Integrating Care for Older Adults with Cognitive Impairment
Integrating Care for Older Adults with Cognitive Impairment
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DOI：
10.2174/156720509788929228
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发表时间：
2009-08-01
影响因子：
2.1
通讯作者：
Hendrie, Hugh C.
中科院分区：
文献类型：
--
作者：
Callahan, Christopher M.;Boustani, Malaz;Hendrie, Hugh C.
预计未来50年，患有阿尔茨海默病和相关疾病的老年人数量将增加两倍。虽然我们可能正处于重要的治疗进展的尖端，但这些进展不会改变数百万已受影响的人的病程。希望技术能够使医疗保健系统免于照顾老年痴呆症患者的需要已经站不住脚了。大多数患有痴呆症的老年人将在初级保健环境中接受医疗护理，这种环境不准备为这些脆弱的老年人提供复杂的护理需求。随着人们越来越重视痴呆症的早期诊断，特别是初级保健将受到这种新的护理责任的越来越大的压力。虽然初级保健可能仍然是老年人护理的中心，但它不能也不应该是护理的全部。我们需要设计和测试新的护理模式，整合更大的医疗保健系统，包括医疗保健以及社区和家庭resources.The本文的目的是描述当前的医疗保健基础设施，重点是初级保健在老年痴呆症患者的护理中的作用。我们总结了最近的创新模式的护理寻求提供一个综合和协调的系统，老年痴呆症患者的护理。我们提出了一个更积极的议程，通过更大的培训，整合和护理提供者的合作，以改善我们的老年痴呆症护理系统的情况。这需要投资于设计和测试一个与我们在寻求治愈方面的国家投资相匹配的经改进的护理基础设施。
The number of older adults with Alzheimer's disease and related disorders is expected to triple over the next 50 years. While we may be on the cusp of important therapeutic advances, such advances will not alter the disease course for millions of persons already affected. Hoping for technology to spare the health care system from the need to care for older adults with dementia is no longer tenable. Most older adults with dementia will receive their medical care in the primary care setting and this setting is not prepared to provide for the complex care needs of these vulnerable elders. With an increasing emphasis on earlier diagnosis of dementia, primary care in particular will come under increasing strain from this new care responsibility. While primary care may remain the hub of care for older adults, it cannot and should not be the whole of care. We need to design and test new models of care that integrate the larger health care system including medical care as well as community and family resources.The purpose of this paper to describe the current health care infrastructure with an emphasis on the role of primary care in providing care for older adults with dementia. We summarize recent innovative models of care seeking to provide an integrated and coordinated system of care for older adults with dementia. We present the case for a more aggressive agenda to improving our system of care for older adults with dementia through greater training, integration, and collaboration of care providers. This requires investments in the design and testing of an improved infrastructure for care that matches our national investment in the search for cure.